Related Experiment Video
Updated: Jan 28, 2026
Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants
Published on: March 14, 2013
Hemodynamics of infants with strong fluctuations of internal cerebral vein
Toshifumi Ikeda1, Yuya Ito1, Ryosuke Mikami1
1Department of Neonatology, Aomori Prefectural Central Hospital, Aomori, Japan.
Insights
High-grade fluctuations in cerebral venous blood flow in extremely low-birthweight infants are linked to blood pressure surges or patent ductus arteriosus. These hemodynamic changes are critical for managing intraventricular hemorrhage risk.
Area of Science:
- Neonatal Physiology
- Pediatric Cardiology
- Neurocritical Care
Background:
- Extremely low-birthweight (ELBW) infants experience high rates of intraventricular hemorrhage.
- Cerebral venous waveform fluctuations correlate with hemorrhage risk.
- Understanding hemodynamic changes is crucial for ELBW infant care.
Purpose of the Study:
- Investigate hemodynamic status changes in ELBW infants during internal cerebral vein perfusion waveform fluctuations.
- Identify underlying factors contributing to these hemodynamic shifts.
Main Methods:
- Evaluated internal cerebral vein perfusion waveform in 192 ELBW infants over 120 hours.
- Identified 67 infants with high-grade fluctuations.
- Subdivided infants based on patent ductus arteriosus (PDA) presence: PDA(-) (n=32) and PDA(+) (n=35).
Main Results:
- PDA(-) group showed significant increases in blood pressure during fluctuations (P < 0.001).
- PDA(+) group exhibited increased renal arterial blood flow interruptions (P=0.04) and pulmonary arterial flow velocity (P < 0.001), indicating left-to-right shunt.
- Hemodynamic instability was observed in both groups, but with different underlying mechanisms.
Conclusions:
- Blood pressure elevation may cause cerebral venous waveform fluctuations in ELBW infants.
- Hemodynamically significant PDA is a potential cause when blood pressure does not elevate.
- These findings aid in acute management strategies for ELBW infants at risk of intraventricular hemorrhage.
Background:
There is a high incidence of intraventricular hemorrhage in extremely low-birthweight (ELBW) infants of low gestational age with high-grade fluctuations in the perfusion waveform of the internal cerebral vein. This study investigated changes in the hemodynamic status of ELBW infants during initial strong fluctuations in the perfusion waveform of the internal cerebral vein.
Methods:
We evaluated the perfusion waveform of the internal cerebral vein in 192 ELBW infants from birth, every 8 h for a total of 120 h. Sixty-seven infants had high-grade fluctuations. On the basis of the presence of patent ductus arteriosus (PDA), patients were subdivided into PDA(-) (n = 32) and PDA(+) (n = 35) groups.
Results:
During the first high-grade fluctuation, the PDA(-) group had significant increases in systolic, diastolic, and mean blood pressure (P < 0.001 for all). The PDA(+) group did not have significant changes in blood pressure but did have significant increases in the number of interruptions or regurgitations of diastolic renal arterial blood flow (P = 0.04) and end-diastolic left pulmonary arterial flow velocity (P < 0.001), indicating increased left-to-right shunt.
Conclusions:
Blood pressure elevation may underlie fluctuations in the perfusion waveform of the internal cerebral vein and lead to the first high-grade increases during acute management of ELBW infants. When no elevation in blood pressure occurred, hemodynamically significant PDA was considered a potential underlying factor.
More Related Videos
Related Concept Videos
02:28Titration Calculations: Strong Acid - Strong Base
A titration is carried out for 25.00 mL of 0.100 M HCl (strong acid) with 0.100 M of a strong base NaOH. The pH at different volumes of added base solution can be calculated as follows:
(a) Titrant volume = 0 mL. The solution pH is due to the acid ionization of HCl. Because this is a strong acid, the ionization is complete and the hydronium ion molarity is 0.100 M. The pH of the solution is then:
01:23Titration of a Strong Acid with a Strong Base
03:22Strong Acid and Base Solutions
02:00Internal Energy
01:31Internal Receptors
03:55Titration Calculations: Weak Acid - Strong Base
For the titration of 25.00 mL of 0.100 M CH3CO2H with 0.100 M NaOH, the reaction can be represented as: